A double-masked three-month comparison between 0.25% betaxolol suspension and 0.5% betaxolol ophthalmic solution

In 352 patients with primary open-angle glaucoma or ocular hypertension, a multicenter double-masked, parallel-group clinical study compared the effects on intraocular pressure and ocular comfort of 0.5% betaxolol ophthalmic solution, a cardioselective beta-adrenergic blocking agent, with 0.25% betaxolol suspension. With twice-daily dosages, baseline intraocular pressure was significantly reduced (P = .0005), with no significant difference between the two groups, at Week 2 and at Months 1, 2, and 3. Further, the prevalence of ocular discomfort upon topical instillation was significantly lower for 0.25% betaxolol suspension than for 0.5% betaxolol solution (P = .0005).     

In vitro translation of messenger RNA from the house dust mite Dermatophagoides pteronyssinus

RNA was extracted from the house dust mite Dermatophagoides pteronyssinus and a polyadenylated [poly(A)+] and non-polyadenylated [poly(A)-] mRNA isolated by oligothymidylic acid-cellulose chromatography. Both preparations were translated in vitro using a cell-free rabbit reticulocyte system. The relative incorporation of 35S-methionine into trichloroacetic acid-precipitable translation products obtained using poly(A)+ and poly(A)- mRNA was 21- and 1.3-fold, respectively, when compared with control translations performed without added mRNA. Sodium dodecylsulphate-polyacrylamide gel electrophoretic analysis of the translation products in combination with autoradiography showed that many proteins with apparent molecular weights in the range 14,000- greater than 67,000 daltons were synthesized. Immunoprecipitation studies performed using a sheep anti-whole mite antiserum showed that several of the synthesized proteins corresponded with mite antigens. These findings were confirmed by coprecipitation studies using crossed immunoelectrophoresis (CIE). A comparison of the CIE data with those obtained with crossed radio-immunoelectrophoresis showed that 6 of the 9 allergens previously described in our laboratory were synthesized, namely Der p I, Dpt 1, 3, 4, 8 and 17. The allergenicity of the lysates was also confirmed by immunoprecipitation studies using a specific anti-human IgE reagent.     

Changes in treatment of advanced laryngeal cancer 1985-2001

OBJECTIVE: In 1991, a randomized study was published and demonstrated that use of nonsurgical therapy (chemoradiation) provided similar survival to total laryngectomy (the gold standard) for patients with advanced-stage laryngeal cancer. The purpose of this study was to assess how treatment of advanced laryngeal cancer was influenced by such developments in non-surgical therapy. STUDY DESIGN: Patterns of care study using National Cancer Database (1985-2001). RESULTS: The percentage of advanced-stage patients treated with chemoradiation increased from 8.3% to 20.8% while the proportion treated with radiation alone decreased from 38.9% to 23.0%. Use of chemoradiation increased at a significantly faster rate after the 1991 publication at both community cancer centers and teaching research facilities. The use of total laryngectomy decreased slightly during this period. CONCLUSIONS: The use of chemoradiation increased after the 1991 publication. It was impossible to determine from the NCDB whether additional patients who could benefit from chemo-RT were not offered or did not complete this treatment option. We recommend that treatment recommendations discussed at tumor boards be recorded in cancer registries.     

Histologic fate of dermal grafts following implantation for temporomandibular joint meniscal perforation: a preliminary study

A study was carried out to evaluate the histologic changes of meniscus perforation repair associated with dermal grafts to the temporomandibular joint of cynomolgus monkeys (Macaca fascicularis) following surgical perforation of the meniscus. Dermal grafts were studied histologically at 3-week, 6-week, 3-month, and 6-month intervals. Results showed early attachment of the dermal graft to the meniscus, followed by gradual incorporation of the graft into the meniscus and subsequent return of the meniscal-graft complex to a normal meniscal architecture.     

An assessment of the usage of the plasma theophylline assay service in a teaching hospital

A four-week assessment of all inpatients who had been prescribed theophylline therapy was carried out at a major Australian teaching hospital. A total of 49 theophylline assays was requested for 36 of 116 patients who were prescribed theophylline. Only 38 (78%) assays were ordered for appropriate indications and at appropriate times. In 26 of the 34 appropriately requested assays that could be followed-up, appropriate action was judged to have been taken on receipt of the assay result. Of the 80 patients who were prescribed theophylline for whom theophylline assays were not ordered, 19 might have benefited from the performance of an assay. It is concluded that the theophylline assay service is not being used optimally.     

Effects of beta-aminopropionitrile after glaucoma filtration surgery: pilot human trial

Beta-aminopropionitrile fumarate, an inhibitor of collagen cross-linking, was used topically in patients after filtration surgery for difficult cases of glaucoma (aphakic, repeat surgery, neovascular). Twenty-three patients received the drug for a total treatment period of three months following surgery. The mean preoperative intraocular pressure was 40.0 +/- 14.1 mm Hg (mean +/- standard deviation). The mean postoperative pressure was 19.0 +/- 8.9 mm Hg, with the mean follow-up at 26.4 +/- 11 weeks. The overall success rate was 74%, with success being defined as an intraocular pressure of 22 mm Hg or less at the last visit. Side effects consisted primarily of stinging immediately after the medication was applied. Inhibition of collagen cross-linking may represent an alternative method to the use of injectable 5-fluorouracil to maintain patency of filtration blebs.     

Parental Substance Abuse and Its Relationship to Severe Aggression and Antisocial Behavior in Youth

Research concerning hypothesized relationships between parental alcoholism and conduct problems in their children has had mixed findings. In this study, general and specific aspects of a possible relationship between a history of parental substance abuse (a category including parental alcohol abuse and parental abuse of other substances) with antisocial behavior and severe aggressive/destructive behavior was studied by reviewing preadmission variables in a large group of hospital-treated children and adolescents. The results indicated that various categories of more specifically defined parental substance abuse (e.g., substance abuse in fathers) were related to severe aggressive/destructive behavior and/or conduct disorder in their children. Parental abuse of nonalcohol substances appears to be more important than parental alcohol abuse in predicting severe aggressive and antisocial behavior. Substance abuse in fathers, especially abuse of substances other than alcohol, also seems more important than substance abuse in mothers in predicting severe aggression and conduct disorder.     

Leadership in the Managed Care Era: Challenges, Conflict, Ambivalence

Mental health organizations are in the midst of massive changes brought about by managed care. This paper explores attitudes and reactions of leaders in mental health organizations to these changes. The leader's own conflicts regarding this approach to mental health care is a major determinant of why some organizations adapt more readily than others. Strategies for leaders that recognize the need to address conflict within the individual and the organization are discussed. The importance of facilitating dynamic interactional processes between leaders and non-leaders in regard to mutual expectations also is emphasized.     

Synovial chondromatosis of the metacarpophalangeal joint: case report and review of the literature

Intra-articular synovial chondromatosis in the hand is rare but should be considered in the differential diagnosis of a swollen, stiff or painful joint. Other possible diagnoses include osteoarthritis, rheumatoid arthritis, gout, trauma and chronic infection, and unless enchondral ossification of loose bodies is seen the diagnosis of synovial chondromatosis may not be made preoperatively. A 69-year-old man with synovial chondromatosis of the metacarpophalangeal joint is reported. The joint was swollen and tender. He had not sustained trauma and there was no evidence of arthritis, involvement of other joints or infection. Complete synovectomy with removal of all loose bodies was successful and his symptoms resolved. Intra-articular synovial chondromatosis is a benign condition, but spontaneous resolution is the exception and surgical synovectomy remains the most effective treatment.     

Andrology: Analysis of sperm movement in relation to the oxidative stress created by leukocytes in washed sperm preparations and seminal plasma

The addition of luminol to unprocessed semen samples resultedin the generation of chemiluminescent signals, the intensityof which was highly correlated with the level of leukocyte contamination.Despite the spontaneous oxidant-generating capacity of seminalleukocytes, no correlations were observed between leukocytecontamination and the fertility status of the subjects or anyaspect of the semen profile, including the motility of the spermatozoaor their performance in a hyaluronate penetration assay. Luminol-dependentchemiluminescence and leukocyte contamination were also correlatedin washed sperm suspensions prepared either by repeated centrifugationor on discontinuous Percoll gradients. However, in such spermsuspensions, the spontaneous generation of oxidants by contaminatingleukocytes (>2x10⁴ leukocytes/ml) was invariably associatedwith a decreased capacity for movement. Moreover, causativeassociations between leukocyte contamination, reactive oxygenspecies generation, lipid peroxidation and impaired sperm motilitywere revealed by experiments involving the selective additionor removal of activated leukocytes. From these observationswe can conclude that low concentrations of leukocytes are acommon feature of the human ejaculate and can impair sperm function,particularly in the absence of seminal plasma. These findingshave implications for our understanding of the importance ofleukocytospermia in defining the fertility of human spermatozoain vivo and in vitro.